You must have a valid prescription from a licensed U.S. healthcare professional for a product that is included in the Bausch Health Patient Assistance Program (PAP).
You are being treated as an outpatient and you do not reside in a hospital, nursing home, correctional facility, or court-appointed program or facility.
Your total annual household income must not exceed 300% of the Federal Poverty Level (FPL) based on household size (Federal Poverty Level Guidelines available at https://aspe.hhs.gov/poverty-guidelines).
You must submit your income documentation
First 2 pages of your latest tax return (e.g., Form 1040)
If you do not file a tax return, provide copies of all sources of your household income. This may include latest Social Security statement, disability benefits statement, unemployment benefits, pension statements, and any other household income documents. NOTE: Child support, food stamps, and/or alimony are not included in your income calculation.
If you appear to be eligible for the Medicare Part D Low-Income Subsidy (LIS), you will be required to access that coverage first. If denied, you will need to provide a copy of the LIS denial letter to be considered for enrollment in the Bausch Health PAP.
You must submit your insurance documentation
You must submit copies of the front and back of your health insurance cards.
You have exhausted all appeal options or not have coverage for the Bausch Health product requested through government health insurance (i.e., Medicare Part D, Medicaid, Medigap, VA, DoD, TRICARE, or other federal or state pharmacy assistance programs).
Questions? Call 1-833-862-8727
